Excellent Response of Infantile Hemangioma with Oral Propranolol: A Case Report
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Background: Infantile hemangioma (IH) is the most common benign tumor in infancy. Most IHs resolve spontaneously and do not require treatment. Therapeutic intervention is necessary for life-threatening IH, tumors posing functional risks, ulceration, and severe anatomic distortion, especially on the face. Beta-blockers, most specifically propranolol, have been shown to induce involution of IH, which should be administered as early as possible to avoid potential complications. Purpose: To report a case of IH with visual impairment treated successfully using oral propranolol. Case: A 4-month-old girl weighing, 6.3 kg, with redness plaques on the right face since 3 weeks after birth. The lesions rapidly increased in size within 2 months, and the lesions on her right eyelid made it difficult to open her right eye. Dermatological examination showed erythematous plaques, compressible and varying in size and ptosis. The patient was diagnosed with periocular infantile hemangioma and was given oral propranolol therapy with an initiated dose 3x1 mg. The dose was increased gradually. The lesions were significantly decreased and she could open her right eye normally after 5 months of propranolol therapy. Discussion: Some cases of IH require early treatment. Early treatment is indicated for IH causing functional impairment. The use of propranolol in the management of IH is very effective in the reduction of the lesions and Has minimal side effects. Conclusion: Early diagnosis and intervention with propranolol for IH play an important role in determining the optimal outcomes.
Bruckner AL, Frieden IJ, Powell J. Infantile Hemangiomas. In: Hoeger P, Kinsler V, Yan A, editors. Harper's Textbook of Pediatric Dermatology. Oxford: Wiley Blackwell; 2020. p. 1425–39.
Léauté-Labrèze C, Harper JI, Hoeger PH. Infantile haemangioma. Lancet 2017; 390(10089): 85–94.
Vivar KL, Mancini AJ. Infantile Hemangiomas: An Update on Pathogenesis, Associations, and Management. Indian J Paediatr Dermatology 2018; 19: 293–303.
MacArthur KM, Püttgen K. Vascular Tumors. In: Kang S, Amagai M, Bruckner AL, Enk AH, Margolis DJ, McMichael AJ, et al., editors. Fitzpatrick's Dermatology 9th Edition. New York: McGraw-Hill Education; 2019. p. 2042–65.
Grzesik P, Wu JK. Current perspectives on the optimal management of infantile hemangioma. Med Ther 2017;(8): 107.
Lydiawati E, Zulkarnain I. Infantile Hemangioma: A Retrospective Study. Berkala Ilmu Kesehatan Kulit dan Kelamin 2020; 32(1): 21.
Chen ZY, Wang QN, Zhu YH, Zhou LY, Xu T, He ZY, et al. Progress in the treatment of infantile hemangioma. Ann Transl Med 2019; 7(22): 692–692.
Harter N, Mancini AJ. Diagnosis and Management of Infantile Hemangiomas in the Neonate. Pediatr Clin North Am 2019; 66(2): 437–59.
Saoji R, Shirolikar M. Successful use of propranolol in infantile hemangiomas. Indian J Drugs Dermatol 2017; 3: 77–80.
El Hachem M, Gesualdo F, Diociaiuti A, Berti I, Vercellino N, Boccaletti V, et al. Safety and effectiveness of oral propranolol for infantile hemangiomas started before 5 weeks and after 5 months of age: An Italian multicenter experience. Ital J Pediatr 2017; 43(1): 4–9.
Tamez HM, Sobel R. Review of the treatment of periocular infantile hemangiomas with beta blockers. Int Ophthalmol Clin 2017; 57(1): 169–76.
Sun LM, Xu Y, Xu MN, Wang M, Su Y, Yuan SM. Diagnosis and treatment of periorbital infantile hemangiomas: Case series and literature review. Int J Pediatr Otorhinolaryngol 2020; 136: 110157.
Samuelov L, Kinori M, Rychlik K, Konanur M, Chamlin SL, Rahmani B, et al. Risk factors for ocular complications in periocular infantile hemangiomas. Pediatr Dermatol 2018; 35(4): 458–62.
Tavakoli M, Yadegari S, Mosallaei M, Aletaha M, Salour H, Lee WW. Infantile Periocular Hemangioma. J Ophthalmic Vis Res 2017;(2): 205–201.
Krowchuk DP, Frieden IJ, Mancini AJ, Darrow DH, Blei F, Greene AK, et al. Clinical Practice Guideline for the Management of Infantile Hemangiomas. Pediatrics 2019; 143(1).
Al-Haddad C, El Salloukh NA, El Moussawi Z. Î’-Blockers in the Treatment of Periocular Infantile Hemangioma. Curr Opin Ophthalmol 2019; 30(5): 319–25.
Püttgen KB. Diagnosis and Management of Infantile Hemangiomas. Pediatr Clin North Am 2014; 61(2): 383–402.
PERDOSKI. Hemangioma Infantil. In: Panduan Praktik Klinis Bagi Dokter Spesialis Kulit dan Kelamin di Indonesia. Jakarta. 2017. p. 324–7.
Yarbrough KB, Tollefson MM, Krol AL, Leitenberger SL, Mann JA, MacArthur CJ. Is Routine Electrocardiography Necessary Before Initiation of Propranolol for Treatment of Infantile Hemangiomas? Pediatr Dermatol 2016; 33(6): 615–20.
Shah MK, Vasani RJV. Use of Propanolol in Infantile Hemangioma. Indian J Drugs Dermatol 2017; 3: 48–52.
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